Insurance companies’ tactics (L&I) that can
adversely affect your health & financial future. (You’ll
be shocked at what they get away with!)

How many employers unknowingly break the law and what
you must do to protect yourself.

Why the “Worker’s Compensation Appeals
Board” is your friend!

What to do if your case has been “denied”
or your care has been “unauthorized.”

Why the ”RIIOD” form is so important!

Why your health care professional must have in-depth
knowledge of the Worker’s Compensation Labor Codes and preferably
not be a ”company doctor.”

What to do if you are not happy with your health care
professional.

What to do if Kaiser, Aetna, and Blue Cross/Blue Shield
(your HMO) won’t treat your work injury.

How to determine if the pains you are having are work-related.

And Much More…

Dear Madame or Sir,

Few things are as important as your employment, and more
so, the income it provides you. Without that income, mortgages or
rents don’t get paid, food does not get put on the table,
and life can become very stressful, very fast. Few things are worse
than financial stress.

When you are hurt on the job, and unable to work, the workers
compensation insurance carrier becomes your source of income, making
you feel like they have great power over you. That too is stressful.

Especially When They Don’t Pay You, Or Deny You Your
Needs!

Getting hurt on the job can even make you feel as though
your job is in jeopardy. It is often for this reason that you may
not get the care or benefits you may be entitled to, or take the
actions you should take, simply because you are afraid to do anything
about your situation or injury without the employer or insurance
company’s approval. All too often this lack of action can
backfire on you and by the time you realize it, your relationship
with your employer or the insurance company has changed and you
no longer feel as though they are looking out for your best interests.

Further, your completely legitimate claim to benefits may have been
reduced by following the advise of the insurance company (L&I)
in seeing one of their “preferred doctors.” In many
cases the claims adjuster handling your case may be quite pleasant
and friendly, and may in fact be doing a good job. But oftentimes…

In An Effort to Minimize Your Benefits, Insurance Adjusters
Can Lie, Manipulate, Instill Fear, And Generally Seek to Control
You and Your Rights!

It is common practice (an everyday occurrence) that insurance
companies will send letters to doctors, employers, and patients
“not authorizing” care or “denying” care
or treatment without any legal basis for doing so. In many cases
the insurance company knows this, but their own statistics show
that this is so effective in reducing costs they do it anyway. Unbelievable,
I know, but done every day none-the-less.

Here is just one common insurance company strategy and
whatever you do…

“Don’t Let This Financial Blackmail Happen
To You!”

The insurance company denies your claim
until you are broke. Without a job or a source of income, and
as a desperate effort to get some money, you waive your future
benefits and agree to a lower settlement.

Hide the work injury,As a result of the misinformation or lack of information,
some employers, fearing an increase in their insurance premiums,
will even unknowingly break the law and…

Fire an injured worker before they file a written claim

And other unethical behavior.

Otherwise ethical, responsible companies or individual
employers that do such things are themselves acting out of fear
and unaware of the consequences. They too can be the victims of
fear and manipulation of some industrial insurance profit motivated
tactics.

After Happily And Loyally Working For Their Employer For
Years, Many Now Injured Workers Experience Complete Betrayal By
Their Employer…

They’re treated differently.

They feel like an outsider.

Their co-workers ostracize them.

In some companies, if there are no injuries filed for the
quarter, everyone gets a bonus…a prize. Imagine how a legitimately
injured worker feels when his or her filing is a source of a loss
for all his or her co-workers!

Very Interesting!

Not very long ago, at the Worker’s Compensation Appeals
Board*, they had two articles posted in the meeting and waiting
area; both of them were studies that have been conducted on fraud
and revealed that fraudulent claims by employees are much less frequent
than first thought, and much less common than people think.

* The Appeals board is where applicants (injured workers),
their attorneys (if they have one), the insurance company’s
attorneys (they almost always have one), the insurance adjuster
and the doctors all go before the judge to resolve issues. For your
information…How many fraud units do you think are investigating
insurance companies? A recent article in the San Francisco Chronicle
stated “Zero” in California in the last four years!
Interesting!?

The RIIOD form (Report of Industrial Injury or Occupational
Disease) must be filled out properly for you to have an L&I
claim. More than once I have seen a claim denied because the form
did not reflect the true circumstances of the injury. Doctors themselves
have made these mistakes and unless your doctor is experienced in
these kinds of cases, you may have your claim closed or denied outright.

Warning!

Here Is One Of The Most Common Tactics Used By Insurance
Adjusters To Keep Legitimate Work Injury Victims From Getting Quality
Care And Benefits They Deserve…

They send a letter to the patient and to his or her doctor
and state that “Health Care Benefits are being denied”…
Then call the patient and tell them that if they continue with their
treatment, they may have to pay for the care out of their pocket.

This denial tactic is such common practice, it could almost
be considered routine.

The insurance companies hope you do not know that in most
instances they must pay, and a lot of doctors offices do not know
the laws that protect the patient and the doctor, so the insurance
company will try this tactic and oftentimes get away with it!

Laws specifically state that no matter what, the doctor
must bill your industrial insurance company and CANNOT directly
charge you for care for your work-related injury!…And if payment
is denied, the doctor must seek to get paid through the Workers
Compensation Appeals Board.

Now, it is also true that many insurance adjusters, employers,
and insurance companies follow the law, treat injured workers very
fair, and provide great service to the employer, the injured employee
and the doctors who treat them.

But those people who have that experience are usually not the ones
ordering this FREE REPORT.

What I commonly find is angered, frustrated, and many times
financially devastated injured workers who just do not really know
what to do.

I have met people who have just quit their job and gave
up or were driven to quit by the treatment and abuse they received
at work.

Another common occurrence is patients who need treatment
and are not getting it, or getting treatment that is not helping,
or that they do not like or want. For example they are taking medicines
that are causing unwanted side effects or are getting therapy that
does not seem to focus on the problem areas. Instead they are getting
supervised general exercise sessions that are not injury specific
and that do not address the actual cause of the problem, pain, or
dysfunction.

Here Are Some Common Questions I Get From Frustrated Injured Workers…

1. “What should I do if I am told who I can and cannot
go to for my work injury?”

Answer: It is not uncommon for any doctor to be denied
authorization to treat the injured worker. That often means absolutely
nothing. Only after hearing about the details of your situation
can I determine if I can help you or not. Just because you are told
where you can and cannot go does not mean you are being told the
truth. In Washington and Oregon you have the right to choose any
doctor you want. L&I (WCB) cannot tell you otherwise.

2. “I want to get care but I belong to Kaiser, Aetna,
BlueCross/Blue Shield (your HMO), Etc…and they do not cover
workers injuries. What should I do?”

Answer: Your personal health insurance has absolutely nothing to
do with worker’s compensation (L&I) or what your treatment
options are. Industrial or worker’s compensation insurance
is different insurance for on-the-job injuries. The employer pays
for it by law. The employee never pays for it by law. The state
of Washington/Oregon has specific laws that apply to this area.
One the biggest being, you do not pay for your treatment.

3. “The insurance company says it will absolutely not authorize
care. What can I do?”

Answer: Although there are some legitimate reasons, there are many
illegitimate reasons as well. If that is the case, then schedule
an appointment with my office immediately. Explain to me the circumstances,
and I will help you get this handled. The fact is that there is
no way I can effectively explain to you in this report the entire
law that applies to this area. Just know it is extensive, and that
it is not easy to legally deny care that is needed to an injured
worker. What they are telling you is oftentimes no the final answer.

4. “Do I need to talk to an Attorney?”

Answer: You may, you may not. Until I talk to you and know
your situation, it would be difficult to advise you on that. Many
injured workers have attorneys, and some do not. But unfortunately
there are a small number of attorneys that do not want you to get
better! The more you recover from your injury, the more your disability
rating goes down. That cuts the total settlement down. This means
the attorney gets a percentage of a smaller number.

This can be the reason why they tell you not to seek this
or that treatment. You may think there is a logical reason, but
there is a financial reason! I know that it is unethical, but it
does occasionally happen. And the worse part is that we are not
talking much in terms of money compared to the pain and agony of
you not getting better.

5. “My pain is causing me great difficulty at work.
What should I do?”

Answer: There are job task checklists, physical capacity forms or
light duty forms that can be filled out. They cover things like
how long you stand, sit, lift, and keyboard on the computer and
so on. These are key documents I use to determine if you should
or should not be working, or what modifications, if any, may be
necessary. I may take you off work. I may have you do modified work.

And The Three Most Common Questions Of All…

6. “Can you take me off work?”

Answer: Yes, if you need to be off work due to pain or an inability
to perform the essential duties of your job. However, if there is
an alternative light duty work I think you can do that is offered,
I would send you back to work while treating you. It is a judgment
call for every doctor, and your input is considered. I take this
responsibility very seriously.

7. “I am not being paid disability by my work. What
do I do?”

Answer: If your claim is being disputed, or your claim
is being investigated during the first 90 days following a filing
and you are not working, you may not be paid disability. In this
situation, you would need to go on State Disability to receive payments
until the investigation is finished or the dispute is resolved.

The State would then recover from the insurance company
at a later time by having a lien against your disability benefits.
This form is available with the State Disability Office. This claim
form is filled out by you and me, and then I sign it and mail it
in.

8. “I have a doctor now that I am happy with. Why
would I see you?”

Answer: If you have a doctor that you are happy with, and
things are going well with the insurance company and your employer,
then you are the exception to the majority who request this report.
But, you must be confident that your doctor understands how WCB
(L&I) operates to avoid potential problems in the future. Getting
another opinion about your claim and your injuries may be of interest
to you.

Did You Know?…

1. You may receive treatment for up to five years following
an injury in many cases, and in some instances, even if your claim
has been “closed.” (I once had an adjuster tell me,
“But Doctor that file is closed.”…I said, “Well,
we need to reopen it then!”)
2. If your current symptoms are from the injury, even if it was
in 1995, 1996, and so on, you may be entitled to reopen your claim
for treatment. I have had to do this for patients when their condition
progressively got worse or when their current condition is from
a flare-up of an older injury.

In case you do not already know, my name is Dr. Wade Burbank, owner
and director of The Accidident and Injury Clinic in Vancouver WA.
We provide second opinions, evaluations, treatment and medical/legal
reports. We provide accurate documentation and appropriate care
of work-related injuries.

For many years, I have been very successful in treating:

LOW BACK INJURIES (Including disc injury)

NECK INJURIES

OTHER INDUSTRIAL-RELATED INJURIES

AUTO ACCIDENT INJURIES

INJURIES INVOLVING NUMBNESS, TINGLING AND WEAKNESS.

It has been both my experience and frustration that injured
workers are often denied benefits they are entitled to; including
things like…

· Appropriate health care by a doctor experienced
in working within the worker’s compensation system (L&I)
and successfully caring for work-related injuries.

· Vocational Rehabilitation (job re-training)

· Disability Benefits.

“My staff and I understand the worker’s compensation
system!”

I would like to make an appointment. Do I need to call
the insurance company myself first? Or what do I do?

If you have been injured and would like a free consultation, second
opinion, or need treatment for your injury, call my office and I
will be happy to help you. You do not need pre-authorization from
the insurance company, and you do not need to call them first.

Thank you for your time and I hope reading this report
was helpful to you!

Sincerely,

Dr. Wade Burbank, Chiropractor

P.S. – If you need more help, have more questions,
or need more information, set up a free consultation and let my
staff know that you only want a consultation. Bring all your documents
you have, such as MRI/x-ray results, reports, and other correspondence.
I will be happy to help you sort it out.

Call the Accident & Injury Clinic: (360) 567-1739 in Vancouver,
WA (We are extremely competent and busy. If your
call goes to voice mail, do not call back – just leave a message.
We will call you back.)

Accident & Injury Clinic

6403 NE 117th Ave #108
Vancouver WA 98662

phone (360) 567-1739

WARNING: Making a false workers compensation claim is a
felony subject to five years in prison or fine up to $50,000.